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https://www.readbyqxmd.com/read/27914503/rationale-and-design-of-the-transcatheter-aortic-valve-replacement-to-unload-the-left-ventricle-in-patients-with-advanced-heart-failure-tavr-unload-trial
#1
Ernest Spitzer, Nicolas M Van Mieghem, Philippe Pibarot, Rebecca T Hahn, Susheel Kodali, Mathew S Maurer, Tamim M Nazif, Josep Rodés-Cabau, Jean-Michel Paradis, Arie-Pieter Kappetein, Ori Ben-Yehuda, Gerrit-Anne van Es, Faouzi Kallel, William N Anderson, Jan Tijssen, Martin B Leon
BACKGROUND: Coexistence of moderate aortic stenosis (AS) in patients with heart failure (HF) with reduced ejection fraction is not uncommon. Moderate AS increases afterload, whereas pharmacologic reduction of afterload is a pillar of contemporary HF management. HYPOTHESIS: Unloading the left ventricle by reducing the transaortic gradient with transfemoral transcatheter aortic valve replacement (TAVR) may improve clinical outcomes in patients with moderate AS and HF with reduced ejection fraction...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27908351/pim1-kinase-overexpression-enhances-ckit-cardiac-stem-cell-cardiac-repair-following-myocardial-infarction-in-swine
#2
Shathiyah Kulandavelu, Vasileios Karantalis, Julia Fritsch, Konstantinos E Hatzistergos, Viky Y Loescher, Frederic McCall, Bo Wang, Luiza Bagno, Samuel Golpanian, Ariel Wolf, Justin Grenet, Adam Williams, Aaron Kupin, Aaron Rosenfeld, Sadia Mohsin, Mark A Sussman, Azorides Morales, Wayne Balkan, Joshua M Hare
BACKGROUND: Pim1 kinase plays an important role in cell division, survival, and commitment of precursor cells towards a myocardial lineage, and overexpression of Pim1 in ckit(+) cardiac stem cells (CSCs) enhances their cardioreparative properties. OBJECTIVES: The authors sought to validate the effect of Pim1-modified CSCs in a translationally relevant large animal preclinical model of myocardial infarction (MI). METHODS: Human cardiac stem cells (hCSCs, n = 10), hckit(+) CSCs overexpressing Pim1 (Pim1(+); n = 9), or placebo (n = 10) were delivered by intramyocardial injection to immunosuppressed Yorkshire swine (n = 29) 2 weeks after MI...
December 6, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27898844/static-and-dynamic-components-of-right-ventricular-afterload-are-negatively-associated-with-calf-survival-at-high-altitude
#3
J M Neary, R D Brown, T N Holt, K R Stenmark, R M Enns, M G Thomas, F B Garry
The purposes of this study were to evaluate mean, systolic, and diastolic pulmonary arterial pressures; pulmonary arterial pulse pressures; and systemic oxygen extraction fraction as risk factors for the survival of suckling calves on one ranch located at an altitude of ≥ 2,730 m in Colorado, USA. A prospective cohort study of 58 calves was performed. Pulmonary arterial pressures and systemic oxygen extraction were measured when calves were approximately 3 mo (86 ± 7 d) and 7 mo (197 ± 6 d) of age. Seven of the 58 calves (12%), 4 steers and 3 heifers, were unaccounted for and presumed dead between 3 and 7 mo of age...
October 2016: Journal of Animal Science
https://www.readbyqxmd.com/read/27893646/acute-right-heart-failure-after-hemorrhagic-shock-and-trauma-pneumonectomy-a-management-approach-a-blinded-randomized-controlled-animal-trial-using-inhaled-nitric-oxide
#4
Andrea L Lubitz, Lars O Sjoholm, Amy Goldberg, Abhijit Pathak, Thomas Santora, Thomas E Sharp, Markus Wallner, Remus M Berretta, Lauren A Poole, Jichuan Wu, Marla R Wolfson
BACKGROUND: Hemorrhagic shock and pneumonectomy causes an acute increase in pulmonary vascular resistance (PVR). The increase in PVR and right ventricular (RV) afterload leads to acute RV failure, thus reducing left ventricular (LV) preload and output. iNO lowers PVR by relaxing pulmonary arterial smooth muscle without remarkable systemic vascular effects. We hypothesized that with hemorrhagic shock and pneumonectomy, iNO can be used to decrease PVR and mitigate right heart failure. METHODS: A hemorrhagic shock and pneumonectomy model was developed using sheep...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27883333/design-of-a-simple-coronary-impedance-simulator-for-the-in-vitro-study-of-the-complex-coronary-hemodynamics
#5
Marco Piola, Riccardo Vismara, Giordano Tasca, Federico Lucherini, Paola Redaelli, Monica Soncini, Claudia Romagnoni, Andrea Mangini, Carlo Antona, Gianfranco Beniamino Fiore
Several novel approaches were recently developed to treat aortic root pathologies. The alteration induced by some of these approaches to the biomechanics of the aortic root could possibly affect the coronary perfusion, compromising the procedural outcome. In this scenario, the need to replicate in vitro the coronary flow pattern in physiological and pathological conditions is becoming crucial for the functional assessment of novel devices and techniques. This article describes the design of an easy-to-use, left-and-right coronary impedance simulator, coupled with native aortic roots for in vitro pulsatile tests...
November 24, 2016: Physiological Measurement
https://www.readbyqxmd.com/read/27881020/cardiac-function-during-resuscitation-from-hemorrhagic-shock-with-polymerized-bovine-hemoglobin-based-oxygen-therapeutic
#6
Eilleen S Y Ao-Ieong, Alexander Williams, Vivek Jani, Pedro Cabrales
Hemorrhage impairs myocardial contractile function and decreases oxygen delivery. This study investigates how polymerized bovine hemoglobin (PolyHb) solutions affect cardiac function after resuscitation from hemorrhagic shock (HS). Hamsters were hemorrhaged and resuscitated with PolyHb at 8.5 g/dL and 11.5 g/dL. Left ventricle (LV) function was assessed during shock and resuscitation using a miniaturize conductance catheter. PolyHb resuscitation had no beneficial effects in cardiac function; it increased cardiac afterload and systemic vascular resistance (SVR) of 46 and 116% for 8...
November 24, 2016: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/27876412/advanced-symptoms-are-associated-with-myocardial-damage-in-patients-with-severe-aortic-stenosis
#7
Ricardo A Spampinato, Manuela Tasca, Michael A Borger, Valerie Schloma, Yaroslava Dmitrieva, Meinhard Mende, Thilo Noack, Elfriede Strotdrees, Friedrich-W Mohr
BACKGROUND: Once aortic stenosis (AS) is severe, patients develop symptoms at different stages. Indeed, symptom status may correlate poorly with the grade of valve narrowing. Multiple pathophysiological mechanisms, other than valvular load, may explain the link between AS and symptom severity. We aimed to describe the relationship between the severity of symptoms and the characteristics of a cohort of patients with severe AS already referred for aortic valve replacement (AVR). METHODS: We analyzed 118 consecutive patients (70±9 years, 55% men) with severe AS referred for AVR...
November 19, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27875533/pulmonary-arterial-capacitance-predicts-cardiac-events-in-pulmonary-hypertension-due-to-left-heart-disease
#8
Koichi Sugimoto, Akiomi Yoshihisa, Kazuhiko Nakazato, Yuichiro Jin, Satoshi Suzuki, Tetsuro Yokokawa, Tomofumi Misaka, Takayoshi Yamaki, Hiroyuki Kunii, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
BACKGROUND: Although pulmonary hypertension due to left heart disease (LHD-PH) accounts for the largest proportion of pulmonary hypertension, few reports on the epidemiological analysis of LHD-PH exist. Recently, pulmonary arterial capacitance (PAC) has attracted attention as a possible factor of right ventricular afterload along with pulmonary vascular resistance. We therefore investigated the clinical significance of PAC in LHD-PH. METHODS: The subject consisted of 252 LHD-PH patients (145 men, mean age 63...
2016: PloS One
https://www.readbyqxmd.com/read/27874244/coarctation-repair-normalizes-left-ventricular-function-and-aorto-septal-angle-in-neonates
#9
Haki Jashari, Katarina Lannering, Mats Mellander, Pranvera Ibrahimi, Annika Rydberg, Michael Y Henein
BACKGROUND AND AIMS: Patients with coarctation of the aorta (CoA) have increased left ventricular (LV) afterload that has been shown to impact the LV and ascending aortic function. We aimed to examine the effect of coarctation on LV function and aorto-septal angle (AoSA) before and after surgical repair. METHODS: We retrospectively studied 21 patients with surgically repaired CoA at a median age of 9 (2-53) days at three time points: (1) just before intervention, (2) at short-term follow-up, and (3) at medium-term follow-up after intervention...
November 22, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27873520/rupture-of-right-ventricular-free-wall-following-ventricular-septal-rupture-in-takotsubo-cardiomyopathy-with-right-ventricular-involvement
#10
June Min Sung, Sung Jin Hong, In Hyun Chung, Hye Young Lee, Jae Hoon Lee, Hyun Jung Kim, Young Sup Byun, Byung Ok Kim, Kun Joo Rhee
Most patients diagnosed with takotsubo cardiomyopathies are expected to almost completely recover, and their prognosis is excellent. However, complications can occur in the acute phase. We present a case of a woman with takotsubo cardiomyopathy with right ventricular involvement who developed a rupture of the right ventricular free wall following ventricular septal rupture, as a consequence of an acute increase in right ventricular afterload by left-to-right shunt. Our case report illustrates that takotsubo cardiomyopathy can be life threatening in the acute phase...
January 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/27866432/maternal-cardiac-haemodynamics-in-severe-pre-eclampsia-complicated-by-acute-pulmonary-oedema-a-review
#11
I Bhorat, D P Naidoo, J Moodley
AIM: To establish alterations in maternal cardiac haemodynamics and function using electrocardiography and echocardiography in severe pre-eclampsia complicated by acute pulmonary oedema. METHODS: An extensive literature search including any research articles, randomised control trials, observational study, case report or expert or consensus statement pertaining to severe pre-eclampsia, eclampsia, hypertensive crises of pregnancy, pulmonary oedema, maternal cardiac haemodynamics, Holter monitoring and maternal echocardiography was done...
November 21, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27865733/systolic-and-diastolic-unloading-by-mechanical-support-of-the-acute-vs-the-chronic-pressure-overloaded-right-ventricle
#12
Tom Verbelen, Daniel Burkhoff, Keiichiro Kasama, Marion Delcroix, Filip Rega, Bart Meyns
BACKGROUND: Right ventricular (RV) mechanical support is well described in cases of sudden increase in RV afterload. In cases of chronic RV pressure overload (e.g., pulmonary arterial hypertension), it has rarely been described. METHODS: The pulmonary artery was banded in 18 sheep. In the acute group (n = 9), we immediately implanted a Synergy Pocket Micro-Pump. Blood was withdrawn from the right atrium to the pulmonary artery. In the chronic group (n = 9), this pump was implanted 8 weeks after banding...
October 17, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27865184/changes-of-left-ventricular-mechanics-after-trans-catheter-aortic-valve-implantation-and-surgical-aortic-valve-replacement-for-severe-aortic-stenosis-a-tissue-tracking-cardiac-magnetic-resonance-study
#13
Gaetano Nucifora, John-Paul Tantiongco, Gareth Crouch, Jayme Bennetts, Ajay Sinhal, Phillip J Tully, Craig Bradbrook, Robert A Baker, Joseph B Selvanayagam
BACKGROUND: Left ventricular (LV) mechanics are impaired in patients with severe aortic stenosis (AS). The aim of the present study was to assess their changes early and late after trans-catheter aortic valve implantation (TAVI) and surgical aortic valve replacement (AVR) using cardiac magnetic resonance (CMR) tissue-tracking imaging. METHODS: In 59 patients with severe AS undergoing either TAVI (n=35) or surgical AVR (n=24), CMR with late gadolinium enhancement (LGE) imaging was performed before and early post-procedure to evaluate LV function and mass, and presence/extent of LGE...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27861431/pediatric-artificial-lung-a-low-resistance-pumpless-artificial-lung-alleviates-an-acute-lamb-model-of-increased-right-ventricle-afterload
#14
Fares Alghanem, Benjamin S Bryner, Emilia M Jahangir, Uditha P Fernando, John M Trahanas, Hayley R Hoffman, Robert H Bartlett, Alvaro Rojas-Peña, Ronald B Hirschl
Lung disease in children often results in pulmonary hypertension and right heart failure. The availability of a pediatric artificial lung (PAL) would open new approaches to the management of these conditions by bridging to recovery in acute disease or transplantation in chronic disease. This study investigates the efficacy of a novel PAL in alleviating an animal model of pulmonary hypertension and increased right ventricle afterload.Five juvenile lambs (20-30 Kg) underwent PAL implantation in a pulmonary artery to left atrium configuration...
November 15, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27856711/pulmonary-vascular-collagen-content-not-cross-linking-contributes-to-right-ventricular-pulsatile-afterload-and-overload-in-early-pulmonary-hypertension
#15
Zhijie Wang, David A Schreier, Hinnah Abid, Timothy A Hacker, Naomi C Chesler
Hypoxic pulmonary hypertension (HPH) is associated with pulmonary artery (PA) remodeling and right ventricular (RV) overload. We have previously uncovered collagen-mediated mechanisms of proximal PA stiffening in early HPH by manipulating collagen degradation and crosslinking using a transgenic mouse strain and a potent collagen cross-link inhibitor β-aminopropionitrile (BAPN). However, the roles of collagen in distal PA remodeling, overall RV afterload and RV hypertrophy in HPH remain unknown. Here, we used the same experimental strategy to investigate the impact of pulmonary vascular collagen content and cross-linking on steady and pulsatile RV afterload as well as RV hypertrophy in early HPH...
November 17, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27855113/comparison-of-novel-physiological-load-adaptive-control-strategies-for-ventricular-assist-devices
#16
Moriz Habigt, Maike Ketelhut, Jonas Gesenhues, Frank Schrödel, Marc Hein, Mare Mechelinck, Thomas Schmitz-Rode, Dirk Abel, Rolf Rossaint
Terminal heart failure (HF) is the most prevalent cause of death in the Western world and the implantation of a left ventricular assist device (LVAD) has become the gold standard therapy today. Most of the actually implanted devices are driven at a constant speed (CS) regardless of the patient's physiological demand. A new physiological controller [power ratio (PR) controller], which keeps a constant ratio between LVAD power and left ventricular power, a previous concept [preload responsive speed (PRS) controller], which adds a variable LVAD power to reach a defined stroke work, and a CS controller were compared with an unimpaired ventricle in a full heart computer simulation model...
November 17, 2016: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/27851698/nitrite-prevents-right-ventricular-failure-and-remodeling-induced-by-pulmonary-artery-banding
#17
Jian Hu, Maryam Sharifi-Sanjani, Stevan P Tofovic
BACKGROUND: Nitrite has been shown to reduce right ventricle (RV) remodeling in experimental pulmonary hypertension. However, whether this effect is due to a reduction in RV afterload (i.e., reduction in pulmonary artery pressure) or a direct effect on the RV itself remains unanswered. We hypothesize that nitrite has direct effects on RV remodeling and studied its effects in mice with pulmonary artery banding (PAB). METHODS AND RESULTS: PAB decreased exercise tolerance, and reduced RV systolic and diastolic function...
November 14, 2016: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/27831998/hemodynamic-performance-of-a-novel-right-ventricular-assist-device-perkat%C3%A2
#18
Daniel Kretzschmar, P Christian Schulze, Markus W Ferrari
Acute right ventricular failure (RVF) is an increasingly clinical problem and a life-threatening condition. Right ventricular assist devices (RVADs) represent a reasonable treatment option for patients with refractory RVF. We here present a novel percutaneously implantable device for RV support.The PERKAT device is based on a nitinol stent cage which is covered with valve- carrying foils. A flexible outlet trunk with a pigtail tip is connected to the distal part. The device is driven by an IABP drive unit which inflates/deflates a standard IABP balloon placed within in the stent cage...
November 9, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27831997/pulmonary-arterial-compliance-improves-rapidly-after-left-ventricular-assist-device-implantation
#19
S Carolina Masri, Ryan J Tedford, Monica M Colvin, Peter J Leary, Rebecca Cogswell
Pulmonary artery compliance (PAC) contributes to right ventricular (RV) afterload, is decreased in the setting of increased left ventricular (LV) filling pressures, and may be an important component of World Health Organization (WHO) Group II Pulmonary Hypertension (PH). Left ventricular assist device (LVAD) implantation can rapidly change LV filling, but its relationship with PAC is unknown. Right heart catheterization was performed pre-operatively, post-operatively (between 48-72 hours), and > 30 days post-LVAD implantation in a cohort of 64 patients with end stage systolic heart failure...
November 9, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27817156/assessment-of-dexmedetomidine-effects-on-left-ventricular-function-using-pressure-volume-loops-in-rats
#20
Kyuho Lee, Hye Jeong Hwang, Ok Soo Kim, Young Jun Oh
PURPOSE: The role of dexmedetomidine on left ventricular function is ambiguous. We analyzed pressure-volume loops to investigate whether dexmedetomidine has a myocardial depressive effect. METHODS: Thirty-two Sprague-Dawley rats were anesthetized and a pressure-volume loop catheter was advanced into the left ventricle. Rats were divided into four groups (n = 8 each). The control group received a 10-min infusion of 0.1 ml of normal saline, and the other three groups received 1...
November 5, 2016: Journal of Anesthesia
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